This CTSA renewal application is built on the research infrastructure, training programs, and partnerships we established in the first grant period, through creation ofthe Institute for Clinical and Translational Sciences (ICTS), which brought about significant cultural and organizational changes at Washington University in St. Louis and unprecedented collaboration between its partner institutions, including BJC HealthCare, Barnes-Jewish Hospital, St. Louis Children's Hospital, Saint Louis University, University of Missouri - St. Louis, Southern Illinois University Edwardsville, Goldfarb School of Nursing at Barnes-Jewish College, and the St. Louis College of Pharmacy. The overall goal of this application is to promote the translation of scientific discoveries into improvements in human health. Our specific aims will transform our research support infrastructure to foster multidisciplinary clinical and translational research, expand and enhance clinical and translational research education programs, and promote communication and collaborative research with regional and national partners. New initiatives include 3 new cross-cutting scientific themes where the resources of our ICTS are most likely to result in high-impact clinical research and its subsequent translation into clinical practice: translating the findings of genetic/genomic research into clinical research and practice, accelerating the development and evaluation of new therapeutics, and conducting comparative effectiveness and dissemination and implementation research to improve the transfer of research into practice. To ensure the continued success of the ICTS, WU has made significant commitments of space and financial support. Barnes-Jewish Hospital and St Louis Children's Hospital, our academic hospital partners, and BJC HealthCare, our affiliated health system, have also made substantial comhnitments to suppport the clinical and translational research activities ofthe ICTS. This institutionalsupport, combined with the programs and collaborations we have started in the past four years, ensure that the ICTS will continue to make outstanding contributions in clinical and translational science. RELEVANCE (See instructions): The overall goal of this grant is to promote the translation of scientific discoveries into improvements in human health. Our proposal will improve clinical research infrastructure, services, and training programs in order to speed the translation of new discoveries from the lab into humans, and to help implement the best medical evidence into clinical practice.